美解眠诱发试验在司法鉴定中对癫痫诊断的价值

The diagnostic value of the megimide stimulation test in the judicial assessment of epilepsy.

在司法鉴定中,对疑有癫痫性人格改变,常规脑电图、脑电地形图检查正常的被鉴定人30例作美解眠诱发试验。在诱发中静脉推注美解眠100mg以内脑电图即出现异常脑波或有临床发作者为阳性。结果经美解眠诱发,有19例呈现癫痫样放电,占63.3%。后再肌注鲁米那0.1克,20分钟后呈现高幅慢波(6Hz)者3例占10.0%,与常规检查有显著差异(P<0.01)。为了提高美解眠激发试验的正确性,应遵守:①严格掌握药物剂量;②必须密切结合既往史;③进行综合性分析评价。这样在司法鉴定中对癫痫的诊断才更有价值。

Objective: To asssess the usefulness of megimide in stimulating epileptiform EEG changes. Method: Thirty patients (age range: 16—45) who had epileptic personality changes but normal routine EEG and BEAM examinations were examined with the megimide stimulation test. Less than 100mg of intravenous megimide was injected. The test was regarded as positive if EEG showed abnormal discharges or if a clinical attack occurred, when an intramuscular injection of 0.1g of phenobarbital was given. Results: There was significant difference between routine and megimide—stimulated EEG examinations(P<0.01). Epileptiform discharges occurred in 19 patients (63.3%) after the megimide stimulating test. Three patients showed slow waves with high voltages (6Hz) after 20 minutes of phenobarbital injection (10.0%). Discussion: The following three aspects must be observed during the correct administration of the megimide stimulating test and for enhancing its value in the judicial assessment of epilepsy. 1. To control the dosage of megemide strictly; 2. To consider patients^(?) past history closely during interpretation; 3. To make a comprehensive.